title: Pre-eclampsia is a potent risk factor for deterioration of retinopathy during pregnancy in Type 1 diabetic patients.
abstract: The aim of the present study was to examine the influence of pregnancy on deterioration of retinopathy in patients with Type 1 diabetes mellitus. Sixty-five pregnant Type 1 diabetic women attending the University Hospital in Lund were studied retrospectively. The degree of retinopathy, and levels of HbA1c and blood pressure 12 months before, during, and 6 months after pregnancy were compared of those of 56 non-pregnant Type 1 diabetic women matched for age and duration of diabetes. For all patients, sight-threatening deterioration of retinopathy did not differ between the pregnancy group (9/65) and the control group (6/56). Over time, pregnant patients had lower HbA1c levels than controls (p < 0.001). Pregnant patients with sight-threatening deterioration of retinopathy had higher HbA1c levels than those without (p = 0.028 and the decrement in HbA1c between the 6-14th and the 20th week of gestation was more pronounced (p = 0.006). In those patients who developed pre-eclampsia during pregnancy, deterioration of retinopathy ocurred more frequently compared to those without pre-eclampsia (4/8 vs 5/65; p = 0.005). In conclusion, sight-threatening deterioration of retinopathy was not more common during pregnancy in IDDM patients than among age- and duration-matched control patients. In pregnant patients, deterioration of retinopathy was associated with the pregestational degree of metabolic control as well as with a rapidly improved glycaemic control acheived during pregnancy. Among those in whom deterioration occurred during pregnancy, pre-eclampsia was a potent risk factor.
authors.affiliation: Department of Ophthalmology, University Hospital, Lund, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Lövestam-Adrian
authors.forename: C D
authors.initials: CD
authors.lastname: Agardh
authors.forename: A
authors.initials: A
authors.lastname: Aberg
authors.forename: E
authors.initials: E
authors.lastname: Agardh
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001794:Blood Pressure / Q000502:physiology*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003930:Diabetic Retinopathy / Q000453:epidemiology / Q000209:etiology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis* / Q000378:metabolism; D006801:Humans; D015994:Incidence; D011225:Pre-Eclampsia / Q000150:complications*; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D012016:Reference Values; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D006442:Glycated Hemoglobin